The most common fly species associated with screwworm myiasis in Southeast Asia is Chrysomya bezziana (Ch. bezziana), the Old-World screwworm. Treatment of screwworm myiasis in cats traditionally has comprised subcutaneous injection of ivermectin or oral administration of nitenpyram, combined with aggressive tissue debridement and larval removal under general anaesthesia. Two cats diagnosed with cutaneous myiasis caused by the larvae of Ch. bezziana were treated with lotilaner. In both cats, a single dose of lotilaner at 6-26 mg/kg, killed all larvae within 24 h, negating the need for general anaesthesia. Both cats were simultaneously infested with Lynxacarus radovskyi (L. radovskyi) which also was eradicated with lotilaner. No adverse reactions were observed and both cats recovered without complications.
STUDY OBJECTIVE: No studies have specifically considered paternal understanding of menstruation. This study aimed to establish the degree of understanding of fathers of adolescent girls with menstrual symptoms relative to mothers.
DESIGN AND SETTING: This was a cross-sectional survey-based study. Adolescent patients attending an outpatient gynecology clinic for dysmenorrhea and/or heavy menstrual bleeding and their parents were invited to complete surveys.
PARTICIPANTS: Sixty surveys were completed (24 of 40 daughters, 20 of 40 mothers, 16 of 40 fathers).
INTERVENTIONS AND MAIN OUTCOME MEASURES: Surveys aimed to test parents' understanding of menstrual symptoms and potential medications, as well as fathers' concerns with their daughters' health.
RESULTS: The fathers' knowledge of menstrual symptoms was poorer than mothers, although most knew heavy menstrual bleeding (15/16, 94%) and mood swings (14/16, 87%). Many parents answered "don't know" or did not answer questions about potential consequences of medications, although parents were clearly concerned about side effects. Most fathers (13/16, 81%) were open to discussing menstrual concerns with daughters; however, only 54% (13/24) of daughters were open to such discussions. Of fathers, 81% (13/16) were sympathetic/concerned, 56% (9/16) felt helpless, and 13% (2/16) were frustrated when daughters were in pain. When asked about effects, 88% (14/16) of fathers (79% [15/20] of mothers) were worried about their daughter's welfare and 63% (10/16) (55% [11/20] of mothers) about schooling.
CONCLUSION: We present, to our knowledge, the first insight into fathers' knowledge of their daughters' menstrual health. Overall, parents have an incomplete picture of menstrual symptoms. Even in this cohort, which could be expected to be well informed because of their daughters' attendance at a tertiary hospital, it is clear that further knowledge would assist them caring for their daughters.
Study site: Adolescent Gynaecology Outpatient Clinic, Royal Children’s Hospital, Victoria, Australia